368_373_03001_altuntas:368_373_03001_altuntas 30.09.

2008 11:42 Uhr Seite 368

Original Article · Originalarbeit

Transfus Med Hemother 2008;35:368–373 Received: March 25, 2008

Accepted: July 1, 2008
DOI: 10.1159/000151351 Published online: September 16, 2008

Comparison of Plateletpheresis on the Fenwal Amicus

and Fresenius Com.Tec Cell Separators
Fevzi Altuntasa Ismail Sarib Ismail Kocyigita Leylagul Kaynara Sibel Hacioglub
Ahmet Ozturkc Mehmet Oztekina Musa Solmaza Bulent Esera Mustafa Cetina Ali Unala
a Department of Hematology and Apheresis Unit, Erciyes Medical School, Kayseri
b Department of Hematology, Pamukkale Medical School, Denizli
c Department of Statistics, Erciyes Medical School, Kayseri, Turkey

Key Words Schlüsselwörter

Plateletpheresis · Apheresis · Amicus · COM.TEC · Thrombozytenapherese · Apherese · Amicus · COM.TEC ·
Cell separator Zellseparator

Summary
Background: A variety of apheresis devices are now available
on the market for plateletapheresis. We compared two aphere-
sis instruments (Fenwal Amicus and Fresenius COM.TEC) with
regard to processing time, platelet (PLT) yield and efficiency,
and white blood cell (WBC) content. Material and Methods:
Donors undergoing plateletpheresis were randomly separated
into two groups (either the Amicus or the COM.TEC cell separa-
tor). Results: In the pre-apheresis setting, 32 plateletpheresis
procedures performed with each instrument revealed no signif-
icant differences in donors’ sex, age, weight, height and total
blood volume between the two groups. However, the pre-
apheresis PLT count was higher with the COM.TEC than with
the Amicus (198 × 103/μl vs. 223 × 103/μl; p = 0.035). The blood
volume processed to reach a target PLT yield of ≥3.3 × 1011
was higher in the COM.TEC compared to the Amicus (3,481 vs.
2,850 ml; p < 0.001). The median separation time was also sig-
nificantly longer in the COM.TEC than in the Amicus (61 vs.
44 min; p < 0.001). 91 and 88% of the PLT products collected
with the Amicus and the COM.TEC, respectively, had a PLT
count of ≥3.3 × 1011 (p = 0.325). All products obtained with both
instruments had WBC counts lower than 5 ↔ 106, as required.
There was no statistical difference with regard to collection effi-
ciency between the devices (55 ± 15 vs. 57 ± 15%; p = 0.477).
However, the collection rate was significantly higher with the
Amicus compared to the COM.TEC instrument (0.077 ± 0.012 ×
1011 vs. 0.057 ± 0.008 × 1011 PLT/min; p < 0.001). Conclusion:
Both instruments collected platelets efficiently. Additionally,
consistent leukoreduction was obtained with both instruments;
however, compared with the COM.TEC instrument, the Amicus
reached the PLT target yield more quickly.
Zusammenfassung
Hintergrund: Eine Reihe von Apheresevorrichtungen für die
Thrombozytenapherese ist mittlerweile auf dem Markt verfüg-
bar. In der vorliegenden Arbeit werden zwei Apheresevorrich-
tungen (Fenwal Amicus und Fresenius COM.TEC) hinsichtlich
der Parameter Separationszeit, Thrombozytengehalt und -effi-
zienz sowie Gehalt an weißen Blutzellen (WBC) verglichen.
Material and Methoden: Spender, bei denen eine Thrombo-
zytenapherese zum Einsatz kam, wurden randomisiert auf zwei
Gruppen verteilt (entweder Amicus- oder COM.TEC-Zellsepa-
rator. Ergebnisse: In einem Vorapherese-Setting zeigten 32
Thrombozytenapheresevorgänge, die mit jedem Instrument
durchgeführt wurden, keine signifikanten Unterschiede hin-
sichtlich Geschlecht, Alter, Gewicht, Größe und Gesamtblutvo-
lumen des Spenders zwischen den beiden Gruppen. Allerdings
war der Präapherese-Thrombozytengehalt mit dem COM.TEC
höher als mit dem Amicus (198 × 103/μl vs. 223 × 103/μl; p =
0,035). Das prozessierte Blutvolumen, das zur Erreichung des
Ziel-Thrombozytengehalts von ≥ 3,3 × 1011 benötigt wurde, war
beim COM.TEC höher als beim Amicus (3481 vs. 2850 ml; p <
0,001). Die mediane Separationszeit war beim COM.TEC signifi-
kant höher als beim Amicus (61 vs. 44 min; p < 0,001). 99 bzw.
88% der Thrombozytenprodukte, die mit dem Amicus bzw. mit
dem COM.TEC gesammelt wurden, hatten einen Thrombozy-
tengehalt von ≥3,3 × 1011 (p = 0,325). Sämtliche mit beiden Ge-
räten gewonnenen Produkte wiesen die vorgeschriebene WBC-
Anzahl von <5 × 106 auf. In Bezug auf die Sammlungseffizienz
gab es keine Unterschiede zwischen den beiden Geräten (55 ±
15 vs. 57 ± 15%; p = 0,477). Allerdings war die Sammelrate beim
Amicus signifikant höher als beim COM.TEC (0,077 ± 0,012 ×
1011 vs. 0,057 ± 0,008 × 1011 PLT/min; p < 0,001). Schlussfolge-
rung: Beide Geräte eignen sich zur effizienten Sammlung von
Thrombozyten. Zusätzlich wird mit beiden Geräten eine deutli-
che Leukoreduktion erzielt. Allerdings lässt sich mit dem Ami-
cus der Ziel-Thrombozytengehalt schneller erreichen als mit
dem COM.TEC.

© 2008 S. Karger GmbH, Freiburg Fevzi Altuntas, MD

Department of Hematology and Apheresis Unit
Fax +49 761 4 52 07 14 Accessible online at: Erciyes Medical School
Information@Karger.de www.karger.com/tmh 38039 Kayseri, Turkey
www.karger.com Tel. +90-532 6588050, Fax -352 4379348
faltuntas@hotmail.com
368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008
Introduction
There are many advantages to donor plateletpheresis. Among
these are the following: economic use of blood due to selective
collection of a relatively large amount of components, possi-
bility of more frequent donations, elimination of unnecessary
component separation in the laboratory, reduced donor expo-
sures and therefore reduced risk of disease transmission and
risk of human leukocyte antigen (HLA) alloimmunization, use
as an effective treatment for already alloimmunized patients,
and labeling as ‘leukoreduced’ without further manipulation
[1–5]. Although improvements in apheresis technology are on-
going, some problems do remain, e.g. the duration of the pro-
cedure and donor discomfort owing to the citrate used for an-
ticoagulation. Minimization of these variables is the driving
motivation behind new apheresis instrument development.
Presently, there are a variety of plateletpheresis instruments
available on the market, and several studies focusing on the
comparison of different plateletpheresis cell separators have
been conducted [6–13]. There is, however, no published data
comparing the Fenwal Amicus and the Fresenius COM.TEC
cell separators.
In the present study, we compared plateletpheresis on the
Fenwal Amicus cell separator (Baxter Healthcare, Deerfield,
IL, USA) and the COM.TEC cell separator (Fresenius Hemo-
Care GmbH, Bad Homburg, Germany) with respect to sepa-
ration parameters and platelet (PLT) yield characteristics such
as processing times, PLT yields, separation efficiencies, and
white blood cell (WBC) content.
Materials and Methods
The study included all healthy volunteer donors between January 2006
and December 2006 who met the Council of Europe Guidelines and Rec-
ommendations for apheresis and the standard guidelines established by
the American Association of Blood Banks [14, 15]. Criteria for eligibility
for a single unit (≥3.3 × 1011) were as follows: 1) age 18–60 years, 2) pre-
apheresis peripheral blood (PB) PLT count ≥ 150 × 109/l, 3) hemoglobin
(Hb) level ≥ 13.5 g/dl, 4) donor body weight ≥ 50 kg, 5) negative tests for
HIV, hepatitis B surface antigen, hepatitis C, and syphilis, 6) absence of
any illness, 7) in good health and feeling well, 8) adequate venous access-
es, 9) at least 3 months since last whole blood donation, 10) at least 3 days
since last plateletpheresis, and 11) no consumption of non-steroidal anti-
inflammatory drugs and acetyl salicylic acid in the last 7 days [16].
The study was approved by the Institutional Review Board. Written con-
sent was obtained after procedural risks were explained in detail before
the procedure. Plateletpheresis donors were sequentially assigned to ei-
ther the Baxter Amicus cell separator or the Fresenius COM.TEC device.
Antecubital veins were used for the venipuncture in all the donors. Senior
apheresis technicians performed all procedures. Vital signs were moni-
tored at the beginning and end of each procedure; donors were also mon-
itored for adverse events during the apheresis procedures. Pre-procedure
donors’ height, weight, sex, and total blood volume (TBV) were also
recorded. None of the donors received routine prophylactic oral or intra-
venous calcium during the apheresis procedure.
Comparison of Plateletpheresis on the
Fenwal Amicus and Fresenius Com.Tec Cell
Separators
11:42 Uhr Seite 369
Instruments
A single Fenwal Amicus instrument with software version 2.52 (Baxter
Healthcare, Deerfield, IL, USA) was used. A double venous access with
a plateletpheresis kit was used per the manufacturer’s recommendation.
The parameters of the Amicus device were as follows: whole blood flow
55–80 ml/min, interface set point 0.60, and anticoagulant/whole blood ratio
1:8–11. The second cell separator used for PLT collection was the blood
cell separator COM.TEC, software version 4.0 (Fresenius HemoCare
GmbH, Bad Homburg, Germany). Per the manufacturer’s recommenda-
tions, we used a double venous access with a C5L kit in a dual-needle pro-
cedure (program PLT5d DN). The machine parameters were as follows:
whole blood flow 50–75 ml/min, interface set point 33, and anticoagu-
lant/whole blood ratio 1:8–12. The following data were entered into the
cell separator program for both instruments: donors’ height, weight, sex,
hematocrit (Htc) and pre-apheresis PB platelet count. The processed
blood volume to reach the target PLT yield (≥3.3 × 1011) was determined
by both instruments. No additional post-procedure processing or filtration
to obtain leukoreduced products was performed on either instrument.
Peripheral Blood Variables
Peripheral blood samples (2 ml, ethylene diamine tetraacetate (EDTA))
were drawn from each donor prior to and 2 h after completion of aphere-
sis. Pre- and post-apheresis complete blood count (CBC) analysis was per-
formed. Donor PLT loss was analyzed using the following formula: PLT
loss = (pre-PLT count – post-PLT count) × 100/pre-PLT count.
Operational Variables
We recorded all procedure times, the processed blood volume to reach
the PLT target yield, the flow rate, and the acid citrate dextrose-A (ACD-
A) volume used.
Platelet Yield Variables
After the PLT container had rested for 1 h without agitation, we obtained
plateletpheresis yield samples with EDTA (2 ml) from the PLT bag for
laboratory analysis. The yield was analyzed for volume, the numbers of
WBC, red blood cells (RBC), and PLT, and swirling. Collection efficiency
(CE) was calculated by the following formulas:
CE = total PLT yield (1011) × 100/(pre-apheresis PLT count + post-
apheresis PLT count/2) × blood volume processed (1).
Blood volume processed = TBV processed – ACD-A (ml) (2).
Collection rate (CR) was calculated by the formula:
CR = PLT yield/separation time (3).
The ratio of PLT yield/blood volume processed was also calculated.
Complete blood counts were determined using an automated blood cell
counter (Sysmex XT 2000i, Roche diagnostics, Sysmex Corporation, Kobe,
Japan), swirling was observed against light, and residual leukocyte con-
centrations in the PLT concentrate were determined by flow cytometry on
a FACS Calibur (Becton Dickinson, Franklin Lakes, NJ, USA) in platelet-
pheresis yields.
Statistics
Data were expressed as the median (range) and mean ± standard devia-
tion (SD). The Amicus and the COM.TEC instruments were compared
Transfus Med Hemother 2008;35:368–373 369
368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008
Table 1. Donors’ characteristics
Amicus COM.TEC p
(n = 32) (n = 32) value
Male/female 29/3 30/2 0.644
Age, years; median (range) 28 (18–43) 29 (21–49) 0.146
Weight, kg; mean ± SD 73.9 ± 10.4 74.1 ± 7.1 0.946
Height, cm; median (range) 170 (155–185) 170 (163–180) 0.839
TBV, ml; mean ± SD 5,142 ± 778 5,197 ± 464 0.696
TBV = Total blood volume.
using an unpaired t-test or the Mann Whitney U test with regard to pre-
and post-apheresis peripheral blood variables, plateletpheresis opera-
tional variables and product variables. An unpaired t-test was used for pe-
ripheral blood variables (e.g. pre-apheresis Hb, pre-apheresis Htc level,
post-apheresis Hb level and post-apheresis Htc level, TBV, body weight of
donor) and plateletpheresis product variables (e.g. collection rate), which
were within normal distribution. The Mann Whitney U test was used for
peripheral blood variables (e.g. pre-apheresis WBC count, pre-apheresis
PLT count, post-apheresis PLT count, post-apheresis WBC count and Hb
loss% and PLT loss%), plateletpheresis operational variables (e.g. blood
volume processed, flow rate, product volume and separation time) and
plateletpheresis product variables (e.g. pH, WBC count/bag and PLT
count/bag), which were not within normal distribution. Data were ana-
lyzed on the SPSS software platform (SPSS 13.0, Chicago, IL, USA). The
level of significance was set at p < 0.05.
Results
The general characteristics of in total 64 donors (n = 32 in the
Amicus group and n = 32 in the COM.TEC group) are given
in table 1. The median age of the donors was 28 (range, 18–43
years) and 29 years (range, 21–49 years) for the Amicus group
and the COM.TEC group, respectively. While there were 29
males and 3 females in the Amicus group, there were 30 males
and 2 females in the COM.TEC group. There was also no sta-
tistically significant difference between the two groups in
terms of weight, height, and TBV of the donors.
Pre- and Post-Apheresis Peripheral Blood Variables
Pre- and post-apheresis PB data are shown in table 2. There
were no significant differences in pre-apheresis Hb levels, Htc
levels, and WBC counts. However, the pre-apheresis PLT
count was significantly higher in patients on the COM.TEC
instrument compared to the Amicus (198 × 103/μl vs. 223 ×
103/μl; p = 0.035); no statistical differences in post-apheresis
PB Hb and Htc levels were noted between the instruments.
The post-apheresis PLT count was significantly lower in the
Amicus compared to the COM.TEC group (144 × 103/μl vs.
164 × 103/μl; p = 0.019); there were, however, no statistically
significant differences between the percentages of PLT and
Hb loss (table 2).
370 Transfus Med Hemother 2008;35:368–373
11:42 Uhr Seite 370
Plateletpheresis Operational Variables
The median blood volume processed to reach a PLT yield
≥ 3.3 × 1011 was significantly higher with the COM.TEC com-
pared to the Amicus (3,481 vs. 2,850 ml; p < 0.001). Addition-
ally, the median flow rate of the Amicus was significantly high-
er than the median flow rate of the COM.TEC (65 vs.
58 ml/min; p < 0.001). Furthermore, there was a significantly
higher median volume of ACD used in collections on the
COM.TEC (373 vs. 300 ml; p < 0.001). However, the mean cit-
rate load per minute was higher in the Amicus compared to
the COM.TEC (6.6 ± 0.8 vs. 6.1 ± 0.5 ml/min) (p = 0.042). The
median time needed for the procedures was also significantly
longer with the COM.TEC (61 vs. 44 min; p < 0.001). The
plateletpheresis procedure data are shown table 3.
Plateletpheresis Product Variables
The plateletpheresis product variables are summarized in
table 4. There were no significant differences in terms of
swirling percent, PLT yield/bag, and WBC count/bag (table 4).
However, PLT yield/blood volume processed was significantly
higher with the Amicus (0.42 vs. 0.33; p < 0.001). The percent-
age of PLT yield ≥ 3.3 × 1011/bag was 91% (29/32) and 88%
(28/32) on the Amicus and the COM.TEC instrument, respec-
tively (p = 0.325). A CE of 55 ± 15% was obtained on the Am-
icus and 57 ± 15% on the COM.TEC (p = 0.477). However,
the CR was statistically higher with the Amicus (0.077 ± 0.012
× 1011 vs. 0.057 ± 0.008 × 1011 PLT/min; p < 0.001). All products
obtained with both instruments had WBC counts lower than
5 × 106, as required. Additionally, the number of products with
<1 × 106 WBC was 30 (94%) with the Amicus and 28 (87%)
with the COM.TEC (p = 0.325).
Adverse Effects of Plateletpheresis
There were no high-rate adverse events that would cause early
termination of the procedure. However, citrate-related mild
toxicity occurred more commonly on the COM.TEC (6
donors) than on the Amicus (4 donors), due probably to the
larger amounts of ACD-A used (300 vs. 373 ml; p < 0.001). All
reactions responded rapidly to decreased flow rates and/or
oral calcium supplementation.
Discussion
Although a variety of apheresis devices are currently available
on the market for plateletpheresis procedures, there are scant
data concerning plateletpheresis with the COM.TEC machine
[13, 17, 18]. Additionally, there is no published data comparing
the COM.TEC and the Amicus instruments used for platelet-
Altuntas/Sari/Kocyigit/Kaynar/Hacioglu/
Ozturk/Oztekin/Solmaz/Eser/Cetin/Unal
368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008 11:42 Uhr Seite 371

Table 2. Pre-and post-apheresis donor CBC

Amicus COM.TEC p value

Pre-apheresis WBC (× 103/μl); median (range) 6.95 (4.4–11.2) 7.55 (5.1–10.4) 0.07
Post-apheresis WBC (× 103/μl); median (range) 6.6 (3.9–9.7) 6.5 (4.0–10.0) 0.746
WBC loss, %; median (range) 11.5 (0–36.2) 16 (0–25) 0.05
Pre-apheresis Hb level, g/dl; mean ± SD 15.6 ± 1.4 15.4 ± 1.3 0.540
Post-apheresis Hb level, g/dl; mean ± SD 14.6 ± 1.5 14.5 ± 1.5 0.882
Hb loss ,%; median (range) 6.5 (0–9.3) 6.3 (3.3–13.6) 0.605
Pre-apheresis Htc level, % 44.5 ± 2.7 43.5 ± 3.2 0.259
Post-apheresis Htc level, % 41.4 ± 3.1 41.7 ± 4.2 0.979
Htc loss, %; median (range) 5.5 (2.2–18.4) 5.9 (0–9.9) 0.171
Pre-apheresis PLT count (× 103/μl); median (range) 198 (159–313) 223 (180–248) 0.035*
Post-apheresis PLT count (× 103/μl); median (range) 144 (105–206) 164 (109–237) 0.019*
PLT loss, %; median (range) 32 (19–40) 29 (3–39) 0.07

WBC = White blood cell; Hb = hemoglobin; Htc = hematocrit; PLT = platelet.

*p = Statistically significant.

Table 3. Plateletpheresis kinetics and

procedural data Amicus COM.TEC p value

Blood volume processed, ml; median (range) 2,850 (2,500–3,500) 3,481 (2,742–4,139) <0.001
Flow rate, ml/min; median (range) 65 (55–75) 58 (50–65) <0.001
ACD-A volume, ml; median (range) 300 (210–341) 373 (294–407) <0.001
Separation time, min; median (range) 44 (37–58) 61 (48–72) <0.001
Product volume, ml; median (range) 285 (260–340) 300 (300–304) <0.001

Table 4. Plateletpheresis product data

Amicus COM.TEC p value

Swirling percent 100 100

PLT yield/bag (× 1011); median (range) 3.39 (2.84–4.03) 3.33 (2.87–3.94) 0.185
Number of PLT yield ≥ 3.3 × 1011/bag 29/32 (91%) 28/32 (88%) 0.325
PLT yield/blood volume processed 0.42 0.33 <0.001*
WBC count/bag (× 106); median (range) 0.30 (0.30–1.20) 0.57 (0.26–1.43) 0.805
Number of yield with WBC < 1 × 106 30 (94%) 28 (87%) 0.399
RBC count/bag (× 106); mean ± SD 4.3 ± 10.2 13.18 ± 15.18 0.008*
Collection efficiency, %; mean ± SD 55 ± 15 57 ± 15 0.477
Collection rate (PLT 1011/min); mean ± SD 0.077 ± 0.012 0.057 ± 0.008 <0.001*

PLT = platelet, WBC = white blood cell.

*p = Statistically significant.

pheresis. This study documents the features of the COM.TEC
and compares it to the widely used Amicus instrument with
respect to parameters such as separation time, PLT yield, CE,
and WBC content. In today’s world, productivity, i.e. ‘doing
more in less time’, is as key a feature as yield when evaluating
equipment. Coffe et al. [17] recorded the French experience
on plateletpheresis with the COM.TEC cell separator; the
blood volume processed was 4,606–5,229 l, and the mean sepa-
ration time was between 87–109 min to reach a target PLT
yield of 4.74 × 1011 to 5.95 × 1011 with the COM.TEC machine.
Moog et al. [18] reported an average processed blood volume
of 2,826 ± 409 ml in a donation time of 55 ± 11 min; the mean
PLT yield of these products was 3.11 ± 0.40 × 1011. Strasser et
al. [13] reported a processed blood volume of 2.49 ± 0.50 l and
a mean separation time of 54 ± 13 min for a mean PLT yield of
2.90 ± 0.54 × 1011 PLT using the COM.TEC. Burgstaler et al.
[9] recorded median separation times of 77 min for a median
PLT yield of 5.03 × 1011 with the Amicus. Additionally, Ben-
jamin et al. [10] reported average separation times of 71.5 min
for median yields of 4.9 × 1011 PLT using the Amicus. In this
study, the median blood volume processed to reach a target
PLT yield of 3.3 × 1011 was significantly higher with the
COM.TEC (3,481 vs. 2,850 ml; p < 0.001). For this reason,
there was a significantly longer mean separation time with the

Comparison of Plateletpheresis on the Transfus Med Hemother 2008;35:368–373 371

Fenwal Amicus and Fresenius Com.Tec Cell
Separators
368_373_03001_altuntas:368_373_03001_altuntas 30.09.2008 11:42 Uhr Seite 372

COM.TEC (61 vs. 44 min; p < 0.001). On the other hand, they
do report that sex, age, weight, TBV and pre-procedure PLT
count affect PLT yield [13, 18]. In the present study, no signifi-
cant differences were noted with regard to sex, age, weight,
height and TBV between the two instruments; however, the
median pre-procedure PLT counts were significantly different
(198 × 103/l vs. 223 × 103/l; p = 0.035). This difference in the
pre-apheresis PLT counts between the two groups may be due
to insufficient numbers of donors per study arm as well as to
performing in different subsequent time periods. Additionally,
there was no statistically significant difference with respect to
the median PLT yield of products per component between the
separators (3.39 × 1011 vs. 3.33 × 1011; p = 0.185).
One important advantage of plateletpheresis is that no further
manipulation is required for the product to be labeled as
‘leukoreduced’. Leukocytes must be <5 × 106 per concentrate
according to USA standards and <1 × 106 per concentrate ac-
cording to European standards [14, 15]. Coffe et al. [17] re-
ported that the residual leukocyte levels were <1 × 106 per
concentrate (mean 0.233 ± 0.150 × 106) in more than 97% of
the components produced (confidence interval (CI) of >95%).
Moog et al. [18] recorded mean WBC contaminations of 0.11
± 0.20 × 106 with the COM.TEC. Strasser et al. [13] reported
that nearly all of the PLT products collected with the
COM.TEC, the AS.TEC204, and the COBE spectra met the
AABB standards as well as the more stringent European
guidelines. Using the Amicus, Laurencet et al. [20] reported
<5 × 106 WBC in 98% of the products and <1 × 106 WBC in
84%. Additionally, some studies have confirmed the consis-
tency of leukoreduction [9–11, 21]. In the present study, all
products obtained with both instruments had a WBC content
<5 × 106 (0.30 × 106 to 1.2 × 106 vs. 0.26 × 106 to 1.43 × 106; p =
0.805). Additionally, the number of products with <1 × 106
WBC was 30 (94%) with the Amicus and 28 (87%) with the
COM.TEC instrument (p = 0.325).
Efficient PLT collection is an important issue when comparing
instruments; the new generation of instruments appears to be
more efficient [9]. In the present study, we noted a CE of 55 ±
15% with the Amicus and of 57 ± 15% with the COM.TEC
(p = 0.477). Compared to results reported in the literature, our
COM.TEC CE results (57 ± 15%) were similar to those re-
ported: 52–55% [13, 17, 18]. However, our Amicus results
(55 ± 15%) were lower than the reported averages of 66–73%
[8–11, 19–22]. On the other hand, when comparing the instru-
ments with regard to PLT yield/blood volume processed, the
Amicus showed a significantly higher ratio compared to the
COM.TEC (0.42 vs. 0.33; p < 0.001). Moreover, while the CR
was statistically higher with the Amicus (0.077 ± 0.012 vs. 0.057
± 0.008; p < 0.001), the CR of both machines was comparable
to that reported in the literature [8, 9, 20, 23].
Efficient platelet collection with fewer procedure-related side
effects is an important consideration for donors. The most
common procedural adverse effects are citrate related [16–18,
24]; the incidence of citrate toxicity varies from 0.11 to 16% in
different studies [8, 25–28]. Citrate-related reactions have
been observed in 0.5% of cases on the COM.TEC machine
[17]. Additionally, Benjamin et al. [10] reported that mild cit-
rate-related toxicity occurred more commonly on the Amicus
than on the Spectra LRS separator, as a result of the larger
amount of ACD used (483 vs. 389 ml; p < 0.0001). However,
these adverse reactions were successfully treated by reducing
the ACD infusion rate, the amount of ACD used and/or oral
calcium supplementation [13, 17, 18]. In the present study,
since there were significant differences between the flow rates
of the devices, separation time and ACD consumption were
also found to be statistically significant (p < 0.001). Addition-
ally, there were statistically significant differences between the
two groups in terms of the citrate load per minute (p = 0.042).
The higher ACD consumption but lower citrate load per
minute of the COM.TEC procedure may be explained with
the low number of donors per arm. Citrate-related mild toxic-
ity occurred more commonly on the COM.TEC (6 donors)
than on the Amicus (4 donors). However, this was not clinical-
ly significant.
In conclusion, both instruments perform plateletpheresis effi-
ciently. Additionally, consistent leukoreduction was obtained
with both machines. The Amicus, however, has the advantage
of a lower separation time.

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